A Study to Delineate the Immunohistological Parameters of Active Versus Stable Vitiligo Using S100, Melan A in Conjunction with CD4 and CD8 Immunohistochemistry Markers
Sai Jyoti1, Minakshi Bhardwaj1, Savitha Sharath2
1Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Research Institute and Dr. Ram Manohar Lohia Hospital, New Delhi, India.
Background:
Vitiligo is an autoimmune pigmentary disorder where it is important to assess the disease status (active/stable) to guide therapeutic decisions.
Aim And Objectives:
We aimed to compare expression of Melan A and S100 in active and stable vitiligo lesions and correlate them with CD4 and CD8 T cells.
Patients And Methods:
Skin biopsies from 45 clinically diagnosed vitiligo patients (25 active and 20 stable) were taken for histopathological analysis. Immunohistochemistry expression for Langerhans cells (S-100), melanocytes (Melan A), and CD4 and CD8 T cells was compared between active and stable vitiligo. Results: Basal cell layer vacuolization and dermal melanophages were more common in active vitiligo (P = 0.003). S100 and CD8 expression were increased in active cases, while CD4 and CD4/CD8 ratio were more in stable cases. A moderate positive correlation between Melan A with CD8 (P = 0.019) and S100 with CD4 (P = 0.013) in active vitiligo was noted.
Limitations:
The limitations of the study include small sample size and lack of control group. There could also be a chance of recall bias in the history given by patient regarding the duration of activity which may have resulted in the misclassification of active versus stable vitiligo.
Conclusion:
We found increased disease activity in the center and margins of active lesions of vitiligo, which can be discerned by decreased expression of Melan A and CD4 as well as an increased expression of S100 and CD8 with concomitant increased basal cell layer vacuolization and dermal melanophages.
